NO PERMIT NUMBER (4)f 'F I ( LOT NO.
STREET
l APPLICATION FOR GAS PERMIT;
• CITY OF CUPERTINO
iUG J 1940
Permit
Fee $ '
'- -'AplIilication is hererm de"to he�Ciy of Cupertino for a permit to install. gas pipes
i
and/or gas appliances,as.aisle&oil; the reyeitse(side,.heSeof:and.agceeS: A�g's� ll�said pipes � and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino,'2rid-lall'other laws applicable thereto.
I -FAMILY RESIDENCE."Use of Premises
'
v
In Owner Address.
BIUE AMARAL P,Uiti—iu.
7�
Phone SANTA CLAY 0�'AZ tti ilA
Address
PLUMBING INSPECTOR
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4 You are hereby ant
Owner or Tenant ..... .....
At ....Aa I r/i 4
............... . ... ...
No.'of Meters ...! ..............
No. of Add. Meters .............
Ito 1160-300
rized to connect the GGAS service for
196.6
New Service ................
Reconnect ..............................
I
Move Service ........................
Move Meter ..........................
. .......... ...........................
./PLUMBING. -INSPECTOR
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